METRO MEDICAL GROUP LLC NPI 1720649064

NPI Information

  • NPI: 1720649064
  • Provider Name: METRO MEDICAL GROUP LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: KETAMINE TREATMENT CENTERS OF AMERICA
  • Address: 3201 W PEORIA AVE STE A105
    PHOENIX, AZ
    ZIP 85029
  • Phone: (480) 676-3555

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NPI Details

METRO MEDICAL GROUP LLC is a family nurse practitioner in Phoenix, AZ. METRO MEDICAL GROUP LLC NPI is 1720649064. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ketamine Treatment Centers Of America.

The provider's business location address is:

3201 W PEORIA AVE STE A105
PHOENIX, AZ
ZIP 85029-609
Phone: (480) 676-3555
Fax: (480) 999-4481

The provider's authorized official is Matthew M Rhodes .
The authorized official title is Member and has the following contact phone number (480) 676-3555.

The enumeration date for this NPI number is 6/26/2019 and was last updated on 8/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WA0400XRegistered NurseAddiction (Substance Use Disorder)No
2163WI0500XRegistered NurseInfusion TherapyNo
3111NR0400XChiropractorRehabilitationNo
4163WP0000XRegistered NursePain ManagementNo
5363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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